| Elisa Chang Md Inc | |
|
960 E Green St Ste 105 Pasadena CA 91106-2443 | |
| (626) 304-0782 | |
| (626) 310-0552 |
| Full Name | Elisa Chang Md Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 960 E Green St Ste 105, Pasadena, California |
| Authorized Official Name and Position | Elisa Lee Chang (PRESIDENT) |
| Authorized Official Contact | 3107099552 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Elisa Chang Md Inc Po Box 1449 Brea CA 92822-1449 Ph: (714) 996-1633 | Elisa Chang Md Inc 960 E Green St Ste 105 Pasadena CA 91106-2443 Ph: (626) 304-0782 |
| NPI Number | 1952700759 |
|---|---|
| Provider Enumeration Date | 08/18/2014 |
| Last Update Date | 10/27/2023 |
| Medicare PECOS PAC ID | 5092936278 |
|---|---|
| Medicare Enrollment ID | O20141103000548 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952700759 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | A117197 (California) | Primary |
| Provider Name | Elisa L Chang |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1811284193 PECOS PAC ID: 8820267180 Enrollment ID: I20141103001051 |
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